Lustig, Sugar, Controversy

"Let me tell you what's happening. You're not a glutton. You're not a sloth. But if you eat a lot of carbohydrate or drink those sweetened drinks, the sugar makes your insulin shoot up. You know that ring around your neck? It means your body has chronically high insulin. That's not good. Insulin steals the energy from your blood and puts it into your fat. Say you eat 1,000 calories. Your insulin grabs 500 of those calories and stores them in your fat tissue. And guess what? You're still hungry and you feel tired."
http://www.psmag.com/health/robert-lustig-sugar-obesity-diet-50948/

Here's a guy who's so right, and so wrong:

"All health debacles were originally categorized as personal travails before they were declared public health issues," Lustig writes in FatChance. "What if our breakfast cereal was laced with heroin by some unscrupulous food company?" Whose fault would it be if people became addicted? "Isn't it the role of the government to protect us?" 

Lustig, and many Americans, don't make the basic connection that government is characterized by ineffectiveness, largely because government only has one tool - force backed by violence.  

Our government, in its zeal to protect us is killing us by advocating a diet that was not supported by science (high carb, high industrial seed oil, and until recently, high sugar).  In short (and I blog at length about government and liberty on my other blog, Apolloswabbie) when "we" allow governments to have the power requisite to "protect" us in the way that Lustig imagines, we ignore a fundamental reality - governments serve the politicians that run them, and their political aspirations, and sometimes by accident do us favors as well.  As Thomas Jefferson stated so eloquently, "The government that governs least governs best."

Back to the part that Lustig is right about: 

The event that sparked his insight: "In 1995, when Lustig was a pediatric endocrinology attending physician at St. Jude Children's Research Hospital in Memphis, Tennessee, a group of children with brain tumors set him on his career course. Lustig noticed that, after neurosurgery to remove the tumors, the children showed signs of hypothalamic obesity. Their hypothalamuses were damaged, and as a result their bodies started producing too much insulin. All became lethargic and fat. Then Lustig prescribed octreotide, a drug that blocks insulin. With no counseling or any effort at behavior modification, all of the children started eating less, moving more, and losing weight. According to Lustig, elated parents started calling him, saying, "I got my kid back!" 

A follow-up study, in 1998, showed that insulin suppression using the same medication caused weight loss in 20 percent of obese adults. Lustig concluded that adiposity-fatness-must stem from a hormonal problem, not a behavioral one. In other words, fat people eat too much and gain excess weight because chemical imbalances make them hungrier and lazier than they should be. These hormonal imbalances cause the behavior, not the other way around. So if you want to fix the behavior, you have to fix the biochemistry."

I think Lustig casting his eye towards government to "make it right" is ironic - he'll have far more success, far faster, using his knowledge to help the people directly. When half the population has figured out that sugar and fructose and these other beasts of "civilization" are killing us, government will come along for the ride.

Eades: Leptin Basics

The venerable Dr. Mike Eades does a nice job explaining about leptin and hunger, and how carb restriction affects these things - more powerfully than drugs.

The drug rimonabant (Acomplia) that failed to pass muster with the FDA panel last week works by blocking some of the hunger receptors in the brain. In other words, those who take the drug – assuming it works as touted – will be less hungry. Less hunger means less food consumption. Less food consumption typically results in weight loss. So, if you take rimonabant, assuming you don’t become suicidal and do yourself in (the big worry of the FDA panel since the major side effects are varying degrees of psychoses), you should lose some weight. But there is a better, cheaper way.

The low-carbohydrate diet working through the hormone leptin reduces hunger much more than rimonabant on its best day. And without the risk of serious side effects. And without the $250 per month for the drug.

http://www.proteinpower.com/drmike/metabolism/leptin-low-carb-and-hunger/

The summary:

1.  Fat makes leptin, so as fat decreases leptin decreases, signaling the brain to make the human hungry.  This way, the human cannot run out of fuel - unless the hunger is not sufficiently motivating (it usually is - funny what millions of years of evolution will do for you) to get the human out to hunt/gather; or, there's inadequate amounts of stuff to be hunted/gathered.

2.  Obese folks have mucho leptin - much more than normal, but their body does not translate the leptin into decreased hunger.  

3. The reason the obese are not leptin sensitive starts with triglycerides - when trigs are high, leptin does not cross the blood brain barrier (BBB), so for practical purposes, the leptin does not exist.  

4.  Carbohydrate restriction helps restore this process by reducing triglyceride levels, which allows leptin to cross the BBB, and restore leptin sensitivity.

Fructose also seems to have a negative effect on leptin sensitivity.

Once again, it's the neolithic levels of carb intake, exacerbated by high neolithic-fructose intake, which drives the system off its energy management program, resulting in humans feeling hungry when they are not in need of more food.

Minor edits 27 July 2012